OPTIMUS DIAGNOSTICS LLC (NPI# 1144609876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144609876 |
| Entity Type | Organization |
| Organization Name | OPTIMUS DIAGNOSTICS LLC |
| Practice Address |
252 Holt Ave Macon GA 31201-1227 |
| Mailing Address |
1005 Boulder Dr Gray GA 31032-6141 |
| Practice Telephone | 8448325414 |
| Practice Fax Number | 8774557176 |
| Mailing Telephone | 4786212100 |
| Mailing Fax Number | 4787440481 |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2016-08-30 |
| Authorized Official Name | MRS. DIANA WILKS (SENIOR VICE PRESIDENT) |
| Authorized Official Telephone | 4786212100 |
| Is Organization Subpart | Y |
| Parent Organization Name | CLINICAL SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | Suppliers |
| Street Address |
252 HOLT AVE |
| City | MACON |
| State | GA |
| Zip Code | 31201-1227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578933453 | Optimus Ultrasound LLC | Clinic/Center | 252 Holt Ave, Macon, GA 31201-1227 | 2015-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| Taxonomy Code | 335V00000X |
| Grouping | Suppliers |
| Classification | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| A supplier that provides one or more of the following portable services, including but not limited to, x-ray, electrocardiogram (EKG), long-term EKG (Holter Monitor), bone densitometry, sonography, and other imaging services in accordance with all state and federal requirements, under the general supervision of a qualified physician. All necessary resources are transported to the patient's location where the services are performed. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: title and definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700190105 | Source Diagnostics of Georgia, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 5559 Thomaston Rd, Macon, GA 31220-8120 | 2010-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982185237 | Guillaume J Pinguet | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 4760 Austell Rd Ste A, Austell, GA 30106-2007 | 2018-08-24 |
| 1790288587 | Acc3 International, Inc. | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3340 Peachtree Rd Ne Ste 2025, Atlanta, GA 30326-1084 | 2018-03-17 |
| 1053858761 | Mobile Medical Imaging of Coastal Georgia, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 5906 Hwy 21 S, Unit 4, Springfield, GA 31326-5505 | 2017-01-20 |
| 1013392315 | Schryver Medical Sales and Marketing, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 3500 Lenox Rd Ne, Suite 1500, Atlanta, GA 30326-4228 | 2015-07-28 |
| 1215316435 | Jlm X-ray LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1015 Canton Street, Roswell, GA 30075 | 2015-05-20 |
| 1023410842 | The Pink Ribbon Mammography and Diagnostic Radiology Services LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 33 Darbys Ave, Hiram, GA 30141-4143 | 2014-09-24 |
| 1477826493 | Mobile Physician Services, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1171 Laurel Pointe, Bogart, GA 30622-2859 | 2012-02-22 |
| 1306140215 | Avery Partners, LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1455 Old Alabama Rd Ste 160, Roswell, GA 30076-2167 | 2011-01-06 |
| 1164670667 | Home Care Imaging | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 187 Sherwood Forest Dr, Douglasville, GA 30134-5808 | 2008-09-09 |
| 1588708119 | Sinorien Healthcare Services | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1462 Montreal Rd Ste 112, Tucker, GA 30084-6904 | 2007-02-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.